Provider Demographics
NPI:1073964508
Name:TAYLOR, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 E NC HIGHWAY 54
Mailing Address - Street 2:BLDG 2000
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5263
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2515 E NC HIGHWAY 54
Practice Address - Street 2:BLDG 2000
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5263
Practice Address - Country:US
Practice Address - Phone:919-493-0959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0105761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical